LOWER LIMB TESTS Flashcards
Inspection of knee
SWEADES + Symmetry to unaffected limb
Gait assessment
- Establishes inability/ability to weight bear four steps
- Considering gait
Examination of Knee
- Palpation of Patella Tendon
- Palpation of Patella cruciate ligaments,
- Joint space, and condyles with knee in slight flexion
- Fibular head must be palpated
Ligaments of the knee
ACL – Front of knee
PCL – Back of knee
LCL – Side towards back
MCL – Side towards middle
ACL drawer test
Patient laying on back, hips 90 degrees and knee bent
Pull knee towards clinician
Increased pain indicates tear and tibial movement a rupture
PCL Drawer test
Patient laying on back, hips 90 degrees and knee bent
Push knee away from clinician
Increased pain indicates tear and tibial movement a rupture
Varus Stress test (LCL)
Patient laying on back
Raise one leg slightly
Apply lateral rotation
Increased pain indicates tear and tibial movement a rupture
Valgus Stress Tests (MCL)
Patient laying on back
Raise one leg slightly
Pull leg towards clinician whilst pressure on thigh
Increased pain indicates tear and tibial movement a rupture
McMurray’s Test
Patient laying on back, knee flexed to 90 degrees
Straighten knee
Flex knee
Rotate in circles
Assess for increased pain
Achilles – Thompson/Simmonds Test
Patient lies face down with feet hanging off edge of bed
When squeezing Calf, if no movement of foot, then test is positive for Achilles Tendon Rupture
Assessment of Joint Movements Above and Below
Ability to wiggle toes
Ability to flex and extend knee
Ottawa rules
Pain in malleolar zone and =
Bone tenderness along the distal 6cm of the posterior edge of the tibia or tip of the medial malleolus OR
Bone tenderness along the distal 6cm of the posterior edge of the fibula or tip of the lateral malleolus OR
An inability to bear weight both immediately and in the emergency department for four steps
Bony tenderness at the navicular
Positive Ottawa rules
X ray necessary because possibility of a fracture
Negativa Ottawa rules
Sprain or strain or soft tissue - give worsening care advice/ UTC - base of of pt SHx
Achilles - Thompson test
Patient lies, face down with feet hanging off the edge of bed when squeeze and calf. If no movement of foot then test is positive for Achilles tendon rupture.
